The Maryland Insurance Administration (MIA) has finalized new regulations that will require coverage of autism benefits, including applied behavior analysis (ABA), for many private plans as well as state employees. Related legislation that would establish a state licensing procedure for ABA providers, meanwhile, is headed to Gov. Martin O'Malley in May.
The new requirements will apply to individual, fully funded small and large group plans, the state employee health plan and coverage purchased through Maryland's health insurance marketplace created under the Affordable Care Act. The coverage includes a minimum of 25 hours weekly of ABA up to age six, and then 10 hours weekly through age 18.
In addition, psychological care and speech, occupational and physical therapy for the treatment of autism are covered.
However, the regulations require ABA practitioners to be licensed by the state. Because Maryland has no license, legislation was moved through the legislature to create the license and will be sent to the Governor next month. Autism Speaks and other advocacy organizations had urged the state to accept professional certification to speed up the process, but MIA insisted on the need for a state license.